The Code of Canon Law, in can. 1003 1 (cf. also can. 739 1 of the Code of Canons of the Eastern Churches) exactly reflects the doctrine expressed by the Council of Trent (Session XIV, can. 4: DS 1719; cf. also the Catechism of the Catholic Church, n. 1516), which states that "only priests (Bishops and presbyters) are ministers of the Anointing of the Sick".

This doctrine is definitive tenenda. Neither deacons nor lay persons may exercise the said ministry, and any action in this regard constitutes a simulation of the Sacrament.

From the Offices of the Congregation for the Doctrine of the Faith, Rome, 11 February 2005, the Memorial of Our Lady of Lourdes.

In these last decades theological tendencies have appeared which cast doubt on the Church's teaching that the minister of the Sacrament of the Anointing of the Sick "est omnis et solus sacerdos". The approach to the subject has been mainly pastoral, with special consideration for those regions in which the shortage of priests makes it difficult to administer the Sacrament promptly, whereas the problem could be overcome if permanent deacons and even qualified lay people could be delegated to administer the Sacrament.

The Note of the Congregation for the Doctrine of the Faith intends to call attention to these trends to avert the risk of possible attempts to put them into practice, to the detriment of the faith and with serious spiritual damage to the sick, whom it is desired to help.

Catholic theology has seen in the Epistle of James (5: 14-15) the biblical foundation for the Sacrament of the Anointing of the Sick. The author of the Epistle, having made various recommendations concerning Christian life, also offers a directive for the sick: "Is there anyone sick among you? He should ask for the presbyters of the Church. They in turn are to pray over him, anointing him with oil in the Name of the Lord. This prayer uttered in faith will reclaim the one who is ill, and the Lord will restore him to health. If he has committed any sins, forgiveness will be his".

In this text, under the action of the Holy Spirit, the Church has identified down the centuries the essential elements of the Sacrament of the Anointing of the Sick, which the Council of Trent (Sess. XIV, ch. 1-3, cann. 1-4: DS 1695-1700, 1716-1719) systematically proposes: a) subject: the seriously ill member of the faithful; b) minister: "omnis et solus sacerdos"; c) substance: the anointing with blessed oil; d) form: the minister's prayer; e) effects: salvific grace, the forgiveness of sins, the relief of the sick person.

Now, apart from the other aspects, the concern here is to underline the doctrinal factor relating to the minister of the Sacrament to whom the Note of the Congregation exclusively refers.

The Greek words of James' Epistle (5: 14), which the Vulgate translates as "presbyteros Ecclesiae" in accordance with tradition, cannot be referring to the elders of the community in terms of age but to that specific category of the faithful who, through the imposition of hands, the Holy Spirit had ordained to tend the Church of God.

The first Document of the Magisterium that speaks explicitly of the Anointing of the Sick is a Letter of Pope Innocent I to Decentius, Bishop of Gubbio (19 March 416). The Pope, commenting on the words of the Epistle of James in reaction to the interpretation which claimed that only presbyters could be ministers of the Sacrament with the exclusion of Bishops, rejected this restriction, stating that presbyters are ministers of the Sacrament and Bishops are too (cf. DS 216).

In any case, Pope Innocent I's Letter, like other testimonies of the first millennium (Caesarius of Arles, the Venerable Bede), provides no proof of the possibility of introducing ministers who are not priests to administer the Sacrament of the Anointing of the Sick.

The following data can be found in the Magisterium and subsequent legislation until the Council of Trent: Gratian, in his Decretum (c. 1140), interprets almost literally the enacting part of the above-mentioned Letter of Innocent I (part 1, dis. 95, can. 3). Then in the Decretals of Gregory IX, a Decretal of Alexander III (1159-1164) is inserted in which he responds in the affirmative to the question of whether the priest can administer the Sacrament of the Anointing of the Sick on his own, without another cleric or lay person being present (X. 5, 40, 14).

Lastly, in the Bull Exsultate Deo (22 November 1439) the Council of Florence asserts as a pacifying truth that "the minister of this Sacrament is the priest" (DS 1325).

In response to the Reformers' contestation that the Anointing of the Sick was not a Sacrament but a human invention, and that the "presbyters" mentioned in the Epistle of James were not ordained priests but elders of the community, the Council of Trent amply expounded on Catholic doctrine in this regard (Sess. XIV, ch. 3: DS 1697-1700). It anathematized those who denied that the Anointing of the Sick is one of the seven sacraments (ibid., can. 1: DS 1716) and that the minister of this Sacrament is only the priest (ibid., can. 4: DS 1719).

From the Council of Trent to the codification of 1917, only two interventions of the Magisterium in some way touched on this topic. They were the Apostolic Constitution Etsi Pastoralis (26 May 1742, cf. 5, n. 3: DS 2524) and the Encyclical Ex Quo Primum (1 March 1756) by Benedict XIV.

In the first Document liturgical norms are presented on relations between the Latins and the Oriental Catholics who, fleeing the persecutions, had arrived in Southern Italy; whereas in the second Document, the Eucologio (ritual) of Orientals who had returned to full communion with the Apostolic See was approved and commented upon (it should be noted that the Orthodox also consider that the minister of the Anointing is only the Bishop or the presbyter).

With regard to the Sacrament of the Anointing of the Sick, it is implied as a peacefully acquired truth that the minister of the Sacrament be "omnis et solus sacerdos". The traditional doctrine expressed by the Council of Trent on the minister of the Sacrament of the Anointing of the Sick was codified in the Code of Canon Law promulgated in the year 1917 (can. 938 1) and repeated with almost the same words in the Code of Canon Law promulgated in 1983 (can. 1003 1) and in the Code of Canons of the Eastern Churches in 1990 (can. 739 1).

All the Rituals of the Sacrament of the Anointing of the Sick have, moreover, always presumed that the minister of the Sacrament be either a Bishop or a priest (cf. Ordo Unctionis Infirmorum eorumque pastoralis curae, Editio typica, Typis Polyglottis Vaticanis, 1972, Praenotanda, nn. 5, 16-19). Therefore, they never contemplated the possibility that the minister be a deacon or a lay person.

The doctrine which holds that the minister of the Sacrament of the Anointing of the Sick "est omnis et solus sacerdos" enjoys such a degree of theological certainty that it must be described as a doctrine "definitive tenenda". The Sacrament is not valid if a deacon or a layman attempts to administer it. Such an action would be a crime of simulation in the administration of a sacrament, to be penalized in accordance with can. 1379, CIC (cf. can. 1443, CCEO).

To conclude, it would indeed be appropriate to recall that through the sacrament he has received the priest makes present in a quite special way the Lord Jesus Christ, Head of the Church.

In the administration of the sacraments, he acts in persona Christi Capitis and in persona Ecclesiae. The person who acts in this Sacrament is Jesus Christ; the priest is the living and visible instrument. He represents and makes Christ present in a special way, which is why the Sacrament has special dignity and efficacy in comparison with a sacramental: therefore, as the inspired Word says concerning the Anointing of the Sick, "the Lord will raise him up" (Jas 5: 15).

The priest also acts in persona Ecclesiae. The "presbyters of the Church" (Jas 5: 14) pray on behalf of the whole Church; as St Thomas Aquinas says on this subject: "oratio illa non fit a sacerdote in persona sua..., sed fit in persona totius Ecclesiae" (Summa Theologiae, Supplementum, q. 31, a1, ad 1). Such a prayer is heard.